Combined Medical Services Examination Page 7


34. A 30 year old lady sustained chest injury in an accident and presented with
massive haemothorax on right side. Tube thoracostomy drained 1800 ml of blood.
What is the most appropriate treatment?
(a) Correction of hypovolemic shock
(b) Put one more chest tube
(c) Clamp the chest tube to cause the tamponade
(d) Resuscitation and prepare for urgent thoracotomy
In a case of obstructed hernia, strangulation is suggested by which of the following?
1. Presence of shock
2. Pain is never completely absent
3. Localised tenderness is associated with rebound tenderness
4. Pain persists despite conservative management
5. An external hernia becomes tense, tender, irreducible, with recent increase in size
Select the correct answer using the code given below:
(a) 1, 2, 3, and 4 only
(b) 1, 2, 4 and 5 only
(c) 1, 3 and 5 only
(d) 1, 2, 3, 4 and 5
36. Regarding haemorrhagic shock, which one of the following statements is correct?
(a) Clinically manifested when > 10% of loss of total blood volume occurs
(b) Tachycardia presents in 100% of hypovolemic patients
(c) Loss of 40% of circulating volume is life threatening
(d) In acute stage of shock, systemic vasodilation becomes evident
Consider the following statements:
Poor prognostic indicators in advanced germ cell tumours show
1. primary sites in mediastinum
2. non-pulmonary metastasis
3. lactate dehydrogenase more than 10 times of normal value
Which of the statements given above are correct?
(a) 1, 2 and 3
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1 and 2 only
38. Which one of the following structures is not removed during a classical radical
neck dissection?
(a) Trapezius
(b) Sternocleidomastoid
(c) Internal jugular vein
(d) Accessory nerve


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